In writing to advertisers, mention Medical Brief. Chancre.-Garretson's treatment for chancre is to destroy it with London paste (equal parts of caustic soda and quick lime), which never causes inflammation or gives pain. It will slough a wart in a few minutes. He removes enlarged tonsils with this agent in preference to the surgical operation, but never uses it on the tongue. He recently sloughed out a large carbuncle with the paste in a comparatively short time. To make the paste, reduce the soda and lime to a powder in a clean iron mortar, previously warmed; mix them intimately. Keep in well-stoppered vials. In Fermentative Disorders of the Stomach, and in corresponding forms of diarrhea, we consider Listerine certainly a safe, and also a valuable preparation. It is not at all unpleasant to take when properly diluted; especially, then, as an internal antiseptic do we recommend its use. It is, however, largely used as an external antiseptic, and its oily constituents give it a more healing and penetrating power than is possessed by a purely mineral solution. As a toilet antiseptic to use after a post-mortem or similar work, Listerine, with its pleasant odor, needs only to be tried to find a permanent place there. Listerine is a very attractive-looking preparation, the liquid being crystal clear, with no sediment or undissolved oils whatever. The Lambert Ph. Co. have introduced their product strictly through the profession, which attests their faith in its efficiency.- Maritime Medical News, Halifax, N. S. Hypnotic. I like the preparation of Bromidia. In the cases in which I have prescribed it, it has had the effect of tranquilizing the nervous system, and inviting calm sleep. WM. H. DAY, M.D., M.R.C.P., M.R.C.S., etc. 10 Manchester Sq., London, W. Eng. Skin Diseases.-Dr. Eichhoff claims that a solution of chlorohydrate of hydroxylamin, 1 to 500, in alcohol or glycerin, is very efficacious as a wash in lupus vulgaris, herpes tonsurans and parasitical sycosis. The surface is painted with the wash from three to five times a day. The results were specially encouraging in lupus. Malted Milk contains no starch. Requires no cooking or addition of milk, but merely to be dissolved in water. Malted Milk has already asserted a leading position among the dietetic preparations, either as a food for infants or adults, and it has received the hearty endorsement of many eminent physicians, who prescribe it largely with very gratifying results. Give Malted Milk a fair trial in many cases requiring nutrition, easy of assimilation, combined with simplicity of preparation, and you can not help being pleased.-So. Pract. Sugar in Urine-A Simple Test.-Dr. H. Hager has suggested the following test: Upon a strip of white filtering or blotting paper place a single drop of urine and carefully heat to dryness. If it contains no sugar the stain is hardly to be seen, or is very faintly yellow; if it contains albumen the stain is of a deeper yellow, and at times with a reddish tinge; if it contains sugar the spot will be of a yellow with a brownish cast, the shade of brown varying in intensity according to the sugar present, and under a magnifier by transmitted light the outer portion of the spot will have darker spots, while normal urine is more of a uniform color. The object of this test is to afford the physician a ready method of bedside determination of urine preliminary to more detailed methods. It can readily be done, using a kerosene lamp as the source of heat. The principal precaution is to avoid an excess of heat. Biliary Calculi.-Dr. H. M. Clarkson, Fauquir City, Va., Member Medical Society of Virginia, says: "I have had the most satisfactory evidence of the value of Buffalo Lithia Water in Biliary Calculi." Business Chances. PROPERTY, PRACTICES, ETC., FOR SALE. Notices will be placed under this head on receipt of 80 cents a line each insertion. About seven words to the line. Money must accompany the notice. For Sale.-A desirable property and practice in a Catholic community, at Bloomsdale, Ste. Genevieve Co., Mo. For particulars, address: CHAS. J. HERTICH, M. D. For Sale.-$1200 will buy a nice residence, span of horses, good buggy and harness, in a booming town in Central Kansas. No opposition nearer than 14 miles. Books show $1800 to $2000. Good pay. Address: Box 53, Niles, Kansas. Book Notices, THE PHYSICIAN HIMSELF, and Things that This is certainly a valuable work to every physician and student, and, if thoroughly read and digested, will be the means of starting many a young physician aright. Owen Meredith, in Lucile, truthfully says: "It is not the deed a man does, but the way that he does it, should plead for the man's compensation in doing it." Many physicians lack professional tact and business sagacity, and to those who have not had these inherent qualities born in them, the next best thing to do is to make an effort to imbibe them from the teachings of others who have made them a study. It will certainly do you good to read this work and profit by its teachings. In the eight editions of this work that have already been distributed, you have ample evidence of its worth. WIT AND HUMOR: Their Use and Abuse. By William Matthews, LL.D., Boston. Chicago: 8. C. Griggs & Co., Publishers. Price $1.50. Dr. Matthews is well and favorably known through his previous works-"Geton in the World," "Words: Their Use and Abuse," "Hours with Men and Books," "The Great Conversers,' ""Mon day Chats of Sainte-Beuve," "Literary Style, and Other Essays,” “Men, Places, and Things." This work is written in a style that both pleases and instructs, and has the air of freshness of thought instead of being filled with dull jokes. It entitles the author to the lasting gratitude of all who have a spark of wit and humor in their make up. It is a very agreeable book and written in the happy vein that has made all of Dr. Matthews works very entertaining. By all means place this work in your library, or where you can lay hands on it, and you will find it a comfort and cheer at times when you greatly need it. DISEASES OF WOMEN. A Manual of NonSurgical Gynecology, designed for the use of Students and General Practitioners. By F. H. Davenport, A.B., M.D., Asst. in Gynecology, Harvard Medical School; Asst. Surgeon to the Free Hospital for Women; Physician to the Department of Gynecology, Boston Dispensary. With numerous illustrations. Philadelphia: Lea Brothers & Co. Price $1.50. Practical works are what the active doctor and close student of medicine must have, and the one under consideration is certainly of that kind. A work for the busy practitioner to treat the gynecological cases which he meets in every-day practice. The principal aim is to teach the student the elementary principles of the methods of examination and the simple forms of treatment of the most common diseases of the pelvic organs, and to help the busy doctor to more fully understand and treat the cases that are exempt from surgical interference except in simple procedures. Diagnosis and treatment have received the most attention. Among the numerous works on this subject, the reader of Dr. Davenport's work will find many things to interest him, and explain points on which he was in doubt. A MANUAL OF CHEMISTRY, for the Use of Medical Students. By Brandreth Symonds, A.M., M.D., Asst. Physician to Roosevelt Hospital, Out-Patient Department, Attending Physician, Northwestern Dispensary, New York. Philadelphia: P. Blakiston, Son & Co. Price $2.00. For sale by MEDICAL Brief. This is a work on general chemistry, containing such matter as is necessary for students to know in order to secure their degrees. Dr. Symonds has prepared physicians for the government medical service, and consequently knows their needs more fully than many who have written on this subject. While this work is intended for students, many physicians could gain valuable information from its pages. We heartily commend the work. THE URINE, THE POISONS, AND THE MILK. Memoranda, Chemical and Microscopical, for Laboratory Use. By J. W. Holland, M. D., Professor of Medical Chemistry and Toxicology, Jefferson Medical College, of Philadelphia. Illustrated. Third Edition, Revised and Much Enlarged. Philadelphia: P. Blakiston, Son & Co. For sale in St. Louis by MEDICAL BRIEF. Price $1.00. WOOD'S MEDICAL AND SURGICAL MONOGRAPHS. Vol. 3, No. 2. New York: Wm. Wood & Co., Publishers. Price $1.00. The contents of this number are the following subjects: "The Treatment of Syphilis at the Present Time," by Dr. Maximilian von Zeissl. "The Treatment of Inebriety in the Higher and Educated Classes," by James Stewart, B. A. "Manual of Hypodermic Medication," by Drs. Bourneville and Bricon. The principal feature of this work is on the subject of hypodermic medication which occupies 238 pages, and in which the authors treat of over one hundred drugs that have been administered hypodermically in diseases. This feature alone should cause a ready sale of this issue. A SOUVENIR.-The Lambert Pharmacal Co., of St. Louis, distributed at the Newport meeting a very handsome little souvenir, containing a list of the officers of the Association, programme of the general sessions, list of Presidents of the Association from 1846 to 1889, and a number of views of Newport. URINALYSIS AND TOXICOLOGY, & Laboratory A second edition of this work following so closely to the first is conclusive evidence that it meets all the requirements. ACCUMULATORS AND THEIR MEDICAL USE. An interesting discourse on storage batteries, well worth the perusal of all who are interested in electricity in medicine. DYSPEPSIA, and Disordered Digestion. By Frank Woodbury, A.M., M.D., Fellow of the College of Physicians of Philadelphia. Detroit: George S. Davis, Publisher. Price, paper, 25 cents. Twenty-three Years Before the Profession. VIBURNUM COMPOUND, OF DR. HAYDEN. FOR FEMALE DISORDERS, Prompt and immediate in its action, without NARCOTICS, Poisons, or A STANDARD REMEDY IN THE LEADING HOSPITALS! We have published the testimonials of Five Thousand Physicians in its favor. FOR VALUABLE 80-PAGE HAND-BOOK FREE, Send your address to THE NEW YORK PHARMACEUTICAL COMPANY, Bedford Springs, Mass. Dispensed by all Beliable Apothecaries. Put up in 4-oz., 10-oz. and 16-oz. Bottles. St. Louis OFFICE:-9th and Olive Bts. NEW YORK OFFICE:-150 Nassau St. LONDON OFFICE:-58 Charing Cross Road, London, W. C. Terms-81.00 a year, in advance. Single Copies, 10 Cents. VOL. XVII. ST. LOUIS, MO., OCTOBER, 1889. Etiology, Morbid Anatomy, Symp- There is a good deal of confusion No. 10. mixed disease, that is, if it were in an etiological aspect a combination of the two specific causes, the typhoid germ and malaria, it would be loth miasmatic and contago-miasmatic. Typho-malarial fever is a miasmatic, not a contagomiasmatic fever, therefore the specific typhoid germ does not enter as an etiological factor in this affection. The so-called typho-malarial fever runs a course resembling, in many respects, that of typhoid fever. There is a specific element that is causative of this type of fever, but it is not the typhoid germ in combination with malaria that produces the typhus-like symptoms. There are two leading elements in the etiology of this affection, namely, septic and malarial, and usually one or the other predominates. In the writer's experience the septic element is the leading one. I do not believe that the speci-ion, is a septic poison that develops in fic poison of typhoid fever is ever present in this type of fever. ETIOLOGY.-In considering the cause of typho-malarial fever. We may differ, in regard to its etiology, from other observers. If we were to refer to the literature of this disease, we would find it very meagre, therefore, we will, in this article, only give our views of its etiology. Typho-malarial fever is generally classed in the same category with remittent and intermittent fever, and it depends on the malarial miasm for its origin. If it were a mongrel, hybrid, or The specific poison that produces the typhoid symptoms, in the writer's opin certain individuals whose systems are saturated with malaria. The septic poison that develops in subjects in malarial districts and produces the abdominal phenomena in malarial fevers by absorption of a poisonous amount into the blood, is an animal poison, I believe it is produced by retained effete matter which spends its poisonous force on all the abdominal viscera, notably, the liver and spleen, though the stomach, duodenum, small and large intestines are all, more or less involved in a morbid state. Of course the above is somewhat speculative, but it is the position I take in present state of our knowledge in regard to the etiology of the so-called typhomalarial fever, and will be until I am better informed by others, who are more competent than I am, to give the true origin or cause, or whether it is a combination of the specific elements of typhoid and malarial fever. MORBID ANATOMY.-There are various changes which take place in the organism of subjects suffering with typho-malarial fever. The liver becomes enlarged, and it is said to resemble, in some respects, that of nutmeg liver. In some cases it is of a bronzed color, and in other cases it resembles the liver of remittent fever, and in some instances it has the appearance of the liver in yellow fever. In the majority of cases the spleen is very much enlarged and is almost black in appearance, and somewhat soft to the touch. Usually the lungs and bronchial tubes are involved to some degree in this affection. Generally there is more or less hypostatic congestion of the lungs, and slight inflammation of the bronchial tubes, which, in some cases, amount to a marked case of secondary bronchitis. The heart is said to be pale and flabby, and resembles the heart in typhoid fever. Rarely is there any notable change in the kidneys, except a slight hyperæmia, which will be noticed more in the cortical substance. The greatest analogy between the morbid anatomy of typho-malarial and typhoid fever is in the lesions of the intestines. The changes in the follicles of the intestinal tract are regarded, by some observers, as being identical with those that take place in a typical case of typhoid fever, but by careful observation there will be found some very marked differences. An attempt to divide into stages the development of the intestinal lesion to correspond to the days and weeks of the fever-the glands will be found in all stages of the morbid process, from slight enlargement to ulceration of the entire gland. The Peyerian patches are the seat of the largest and most extensive ulceration of the alimentary canal. The mucous membrane of the stomach and large intestines will be found thickened and softened and in some cases ulceration of a considerable extent, resembling, in some respects, that found in subjects who died of dysentery. By careful observation it will be found that the septic poison, in this form of fever, produces quite a different affect on the glandular follicles of the bowels from that produced by the specific germ or poison of typhoid fever. SYMPTOMS.-To picture a typical case of this fever would be a difficult matter, as there is so much variation in its clinical history it would be almost impossible to describe, in detail, symptoms of a fever that is modified, in its course, by so many circumstances that are essentially connected with it. These is no fever, of which I have any knowledge, that presents so many different phases as the one under consideration. You rarely ever see two cases that presents the same train of symptoms. In this type of fever there are two modes of onset. One by a rigor, more or less severe, and in the other the symptoms that are characteristic of the fever gradually come up until the disease is fully developed. In the author's experience, cases that are ushered in with a severe chill are more apt to be of a grave charter than those cases that are developed slowly. In some instances there is no promonitory symptoms, the patient is suddenly seized by a distinct chill which lasts from one-half to one and a-half hours, and the patient passes into a delirious state of mind, which is usually a grave sign. In other cases the subject's previous health gradually declines. Pains are complained of in the back, limbs, and headache, with loss of appetite, and a state of malaise. The countenance has a peculiar waxy appearance, which is accompanied with a slight rise of fever, which at first resembles simply remittent fever. If the leading element is malaria, there is always more or less remission of temperature which is commonly in the morning, and in some cases there is remission or even intermission of all symptoms; and, on the other hand, if the septic element predominates the tempersture runs a more uniform course, that is, there is no well marked remission, the temperature gradually gets higher each |